Many people become addicted to opioids because they were prescribed them for pain
For those who don’t already know, many people become addicted to opioids through legitimately being prescribed them. Imagine you are working in a warehouse1, and you mess up your back lifting heavy boxes, thus requiring surgery. Back surgery is extremely painful to recover from, and you’re prescribed hydrocodone (or oxycodone or something similar) to help with the pain — a very legitimate reason, and a very understandable one.2
Opioid pills, speaking from personal experience, are very effective in alleviating pain. For some people, it produces very pleasurable effects — some even experiencing euphoria. Here is a write-up from Johns Hopkins that characterizes it better than I can:
Typically, opioids produce pain relief and, for some people, euphoria ― a sense of heightened well-being. Experiencing euphoria after taking opioids may be a warning sign of vulnerability to opioid addiction. This euphoria can even occur in people using opioids as prescribed by their doctor.
Early in the process of opioid use disorder, people may take an opioid drug because of the pleasurable effect. Over time, the pleasant sensations diminish. A person may take opioids more frequently or at higher doses to restore the euphoria or, as the condition progresses, to avoid withdrawal symptoms.
As many as 1 in 4 people receiving long-term opioid therapy develop opioid use disorder, according to CurbtheCrisis.org — that’s a frightening statistic. It means almost anyone can find themselves addicted to opioids through no fault of their own.
Visualizing the crisis in Appalachia
Big Pharma saw dollar signs painted on the backs of the poor working-class in Appalachia, and they descended on the region like birds of prey.
The National Opinion Research Center (NORC) at the University of Chicago developed this tool to visualize the overdose rates in Appalachia on opioids versus all drugs from 2010-2019. The visualization is alarming. Some of the darkest blue counties are also some of the poorest in the region (and the country).
The new non-opioid pain medicine
Obviously, having a non-opioid alternative to pain management that can achieve the same or similar pain mitigation results without the risks of addiction, dependency, overdose, etc. would be a huge step toward ending the opioid crisis.
Last Thursday, the FDA approved Jounavx (no clue how the hell to pronounce it). Here is a snippet from their press release:
Today, the U.S. Food and Drug Administration approved Journavx (suzetrigine) 50 milligram oral tablets, a first-in-class non-opioid analgesic, to treat moderate to severe acute pain in adults. Journavx reduces pain by targeting a pain-signaling pathway involving sodium channels in the peripheral nervous system, before pain signals reach the brain.
Journavx is the first drug to be approved in this new class of pain management medicines.
Pain is a common medical problem and relief of pain is an important therapeutic goal. Acute pain is short-term pain that is typically in response to some form of tissue injury, such as trauma or surgery. Acute pain is often treated with analgesics that may or may not contain opioids.
According to Time, this is the first non-opioid painkiller to be approved in 20 years!
Look, I am not even remotely close to being an expert in any of this, so take what I say with a grain of salt, but that is a long-ass time. And feels like a shameful amount of time to be honest.
For you medical nerds who want to know more about how the medication actually works to target pain receptors, Time has a pretty decent blurb written in terms my medically-dumb brain can understand. (I’ll spare you the length of including it in here).
The truth isn’t a ball-buster, but it’s not a slam dunk either
I am, admittedly, a glass half-full kind of guy sometimes when I know damn well I shouldn’t be. I try my best to reign that side of me in, but at times I cannot help it because DAMMIT I want to believe good things CAN HAPPEN sometimes!3
While I think this is a good thing, I think it’s important to manage expectations. Based on my reading, this will most certainly not be replacing all opioids with non-addictive pain medicine overnight. However, it does appear to show some promise. Check out this blurb from the AP:
“It’s not a slam dunk on effectiveness,” said Michael Schuh of the Mayo Clinic, a pharmacist and pain medicine expert who was not involved in the research. “But it is a slam dunk in that it’s a very different pathway and mechanism of action. So, I think that shows a lot promise.”
Studies in more than 870 patients with acute pain due to foot and abdominal surgeries showed Vertex’s drug provided more relief than a dummy pill but didn’t outperform a common opioid-acetaminophen combination pill.
For more information: https://appodlachia.substack.com/p/a-new-way-to-fight-the-opioid-epidemic?r=19p7p3&utm_campaign=post&utm_medium=email&fbclid=IwY2xjawIW6mFleHRuA2FlbQIxMQABHbYdhH8HwU_AuSHUPPzT9SkcI1jRRzHMv5gidzytd1qRXm-XekpG0ZguCA_aem_B5lGkVY2K5yUhAZcIe_54w&triedRedirect=true